Weber-Christian panniculitis: A review of 30 cases with this diagnosis

• Published in: Journal of the American Academy of Dermatology Vol. 39; no. 1; pp. 56 - 62
• Main Authors: White, John W., Winkelmann, R.K.
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.07.1998; Elsevier
• Subjects: Adult; Aged; Biological and medical sciences; Diagnosis, Differential; Erythema Nodosum - diagnosis; Factitious Disorders - diagnosis; Fat Necrosis - diagnosis; Fat Necrosis - pathology; Female; Granuloma - pathology; Humans; Leukemia - diagnosis; Lymphocytes - pathology; Lymphoma - diagnosis; Male; Medical sciences; Middle Aged; Neutrophils - pathology; Panniculitis - classification; Panniculitis - diagnosis; Panniculitis - pathology; Panniculitis, Nodular Nonsuppurative - diagnosis; Panniculitis, Nodular Nonsuppurative - pathology; Panniculitis, Nodular Nonsuppurative - psychology; Phlebitis - diagnosis; Postphlebitic Syndrome - diagnosis; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis; Skin - injuries; Skin Neoplasms - diagnosis; Human; Weber Christian panniculitis; Symptomatology; Skin disease; Adipose tissue disorders; Diagnosis
• ISSN: 0190-9622; 1097-6787
• DOI: 10.1016/S0190-9622(98)70402-5

Background: More than 60 years ago, Christian described a panniculitis that was later termed Weber-Christian disease . Objective: The purpose of this study was to investigate whether this is a specific disease or a nonspecific disease that embraces several specific conditions. Methods: We studied 30 cases diagnosed as Weber-Christian panniculitis and found it possible to make a more specific diagnosis. Results: In 12 patients, findings were compatible with erythema nodosum. Six patients had phlebitis or postphlebitic syndrome. Factitial panniculitis was diagnosed in five patients, and trauma had a role in the conditions of another three patients. Cytophagic panniculitis, lymphoma, and leukemia were recognized in one patient each. The lesion was lobular in almost all cases, and the presence of lipophagia was noted in 19 biopsy specimens. Granulomatous, neutrophilic, and lymphocytic pathologic changes were present in nine, eight, and eight tissue specimens, respectively. Conclusion: The recognition of distinct disease patterns of fat lesions as fat necrosis with pancreatic disease, α 1 -antitrypsin panniculitis, lupus and connective tissue disease panniculitis, involution lipoatrophy, lipomembranous panniculitis, factitial panniculitis syndromes, calcification panniculitis, lipophagic lipoatrophy, and cytophagic panniculitis has lessened the need for a less specific panniculitis category. All these diseases have been reported in the literature as “Weber-Christian disease.” Because separate and distinct forms of fat lesions have been described, we believe that the eponym should be abandoned and that more specific diagnoses should be made on the basis of pathogenesis or cause. (J Am Acad Dermatol 1998;39:56-62.)